General Question

What form of birth control, if any, should I use?

I have not used any form of birth control for about two years now. (I realize this is super bad! Please don’t lecture me too harshly!)

Details! – I used to be on Ortho Tri Cyclen Lo. I was really, really awful at remembering to take it. If I tried again now, I probably would not be any better. – When I ran out of pill packs one time, I just stopped taking anything entirely because it wasn’t like the pill had been doing anything anyway, since I was taking it so infrequently. – I probably have fertility issues. I have been having sexual intercourse regularly for these past two years (4–5 times per week), and I have not gotten pregnant, despite the complete lack of birth control. – I do not need the birth control to protect me from STDs, as I am monogamous. – I am against using condoms in a relationship as I detest how they feel and also feel as if they detract from intimacy. – I tried Nuvaring. It rubbed against partner’s penis (very uncomfortably for him) during intercourse. – I am worried about weight gain with Mirena, and I am also uncertain as to whether it would be covered by my insurance. (If it was not covered, it would cost around $1600.) – My gynecologist advised against the patch because she said that, after sticking it in one spot for too long, skin becomes discolored, and there are only so many discreet places you can put it. – I am 23 years old, and I probably do not ever want to have biological children. – If I were to get pregnant, I would have an abortion, but I don’t think abortion should be used as a form of birth control, and since I’m not on birth control, I guess that’s what I’d be doing. – I have the worst periods in the world. Unbelievable cramping, completely disabled for first day of period, short cycles, long heavy periods. I probably have endometriosis.

Given these details, what do you think? Should I just continue to use nothing? Something else?

52 Answers

I’ve heard good things about the MucousMethod. You might want to look into that. You might also want to look into birth control shots I linked specifically to the benefits and disadvantages, one of the benefit is a short, lighter period for most women – although some experience heavier periods.

I would also strongly recommend going to your gynecologist to get thoroughly examined if you think you may have fertility issues or endometriosis as they can both be part of larger problems and be quite serious on their own.

You could also try the shot (as mentioned above) or an IUD that isn’t Mirena (Mirena is for women who have had children already; there are other IUDs). Spermicide is an option (although it requires that you plan ahead), and I know someone on the patch who has not had any problems with skin (she switches hips each week). Are you Caucasian? I’ve heard that the majority of skin discolorations is with non-white skin.

Also, I had to go through three rounds of trying different brands of pills before I found a good one for me. If you can find a way to help yourself remember (ie set an alarm on your phone, make sure the pill is always with you in your purse or what have you, etc), you can train yourself to remember. And there is really a window of time during which you can take the pill, up to about an hour after your designated time. Maybe I’m just being an advocate because I swear by Femcon Fe.

I loved the depovera shot….the only problems I had were coming off of it when I went to travel for a few years, with no one to administer it. My periods were light / non existant the whole time, but very heavy and long for the 1st month with out it. I have heard people say that it messed with them psychologically and made them semi crazy, but I never experienced that. Good luck!

If you don;t use something you are playing Russian Roulette. I went off the pill when we decided to have a baby and I got pregnant in 6 weeks. We had decided to have 2 children close together and then shut up the shop so I didn’t go back on the pill. Well I didn’t get pregnant again but a lot of things were happening so it sort of slipped out of consciousness. After 3 years I had a first trimester miscarriage so another baby was still out there. After another couple of years we broke up and weeks later I realized I was pregnant, just at the worst possible time.

I’d recommend taking another look at Nuvaring… you can take it out during intercourse and it’s still effective (you just have to remember to put it back afterwards). Plus, it’s a low dose of hormones, so there are fewer side effects.

Fertile until proven otherwise. If you seriously think you may be infertile (or that your partner might be), check with your doctor to see if he or she can verify it. Until then I’d consider what these fine jellies have recommended.

Abandoning birth control is not worth the risk of getting pregnant, unless you and your partner are 100% sure an abortion is the way you will proceed, and even then abortions shouldn’t be used as birth control.

Sounds like you need something that isn’t taken once a day or needs you to remember regularly This seems to say IUD or Depo shot. I used NuvaRing for a bit and I had issues remembering to put it back in after having sex (I don’t care what they say, any medium to large sized penis WILL find that ring if it remains in the vagina).

So, it seems like there are a lot of recommendations for The Shot. I avoided even mentioning this option in my details because I was under the impression that no one liked The Shot because it typically resulted in the most extreme weight gain. Weight gain would be a gigantic issue for me in choosing my birth control method because I am very fit and have worked hard (with exercise) to achieve my ideal body. I have an extensive and expensive wardrobe, and all of my clothes are extremely form-fitting. If I were to gain even 5–10 pounds, none of my clothes would fit me properly, and I would look like I was wearing clothes that were inappropriate for my body. Buying an entire new wardrobe is not what I am looking to do… For those who have suggested the shot, what is the situation with weight gain?

@TitsMcGhee: Yes, I am Caucasian. So I guess the Patch is a possibility, but, ehhh, I wasn’t a big fan of the idea of always having some bandaid-type thing on my body anyway. I dunno.

I guess the IUD is still a possibility, provided that it is covered by my insurance. (Paying $1600 for birth control is a bit over my current budget as a graduate student.) My main concern with this is, of course, weight gain. Also, this may sound silly, but I also remember hearing that the tip of the IUD has a tendency to “poke” and hurt a partner’s penis. Is this only if the IUD is inserted incorrectly? My partner is rather large downtown, and so I worry about his comfort in that situation.

@Amoebic: No, I was not on OTC Lo because of a sensitivity to the hormones. It was just what I was given because it was believed to be desirable over the full dose of hormones by providing fewer side effects (while being just as effective). I never tried anything stronger.

@Kevisaurus: Condoms are not a possibility for the reasons mentioned by me and acknowledged by @MacBean. I cannot even imagine having a supply of them by the bed. I have not used them in years, my partner does not like them, and they would completely change our spontaneous style. This is also a concern with the removal of NuvaRing. And would be with spermicide. I really value the ability to just go for the sex in the moment without needing to do anything in advance.

@asmonet: As for family planning methods, I guess that would be a logical option as well, but I can’t imagine having to follow a calendar, taking careful note of where I am in my cycle, and avoiding having sex on certain days. Not really our style either.

Gah. Sorry I am so picky. Thanks for everyone’s help so far, and it would be great if people with knowledge of the various methods could address the concerns I have them.

@DrBill: I do have insurance. Vasectomies are low-risk and reversible, but though the initial procedure is inexpensive, reversal can costs tens of thousands of dollars and is not always possible. We are young, and though we do not currently believe we would want biological children, I do not feel as if we are in a position to make that judgment for the rest of our adult lives.

@girlofscience: I understand the concern with the patch. The IUD, as far as I’m aware, should not interfere with intercourse. Unlike Nuvaring, it is inserted by a physician, is smaller in size, and sits in a different place in the uterus. If he can feel it, it is definitely placed incorrectly, which is not true of the ring. This diagram shows where an IUD is placed, beyond your cervix, where your partner shouldn’t be able to reach. It is also designed to last for 3 to 5 years, and must be removed by a physician as well. As far as weight gain is concerned, every person is different. I didn’t have any weight gain when I went on birth control, and I know people who have been on the extremes on both ends. The good thing about an IUD is that it can be removed at any time, putting you back to normal fertility very quickly.

I strongly suggest you talk with a doctor, given that you are so picky about this issue. However, there is still lots that the collective can provide.

I have yet to find one method of hormonal birth control that does not cause weight gain. I believe it’s simply because of the way it works, in tricking your body into believing it is in the early stages of pregnancy, and this causes the body to start gaining a bit of weight in preparation for the non-existent baby.

@DrBill: The thought that vasectomies are reversible is a bit incorrect. While they can be reversed sometimes successfully, it is not a guarantee at all. I would not consider a vasectomy to be something temporary. Tubal ligation on the other hand is much more risky and has very low chances of successfully being reversed.

I don’t get it..in another post on this site, you say you’ve been on the pill for five years…?

I’ve told you my personal opposition to the IUD, my friends have all had excessive weight gain, or lost the IUD and needed painful procedures to find it..or it punctured the uterus.
Everything can have negative side effects, I think the IUD just has more severe things that could go wrong.

I was on Depo shot for two doses (six months) I lost A LOT of weight on it. The nurses said they’d never seen anyone lose weight on it before. I actually liked Depo, but have heard many stories of it causing PCOS. But, if you don’t care about your future fertility..then go for it. I personally won’t go on it, because I want more children and it can affect your fertility for a while. The no periods is awesome though. Oh, I know why I came off of it, the damn acne! Ugh, it was awful! Depo is progesterone based (unlike most pills, which are estrogen) so it causes acne.

I don’t think YOU have infertility issues, I think your partner does. I wouldn’t recommend a vasectomy though, because you might change your mind on having biological children (doubt you guys will though.)
I hated NuvaRing too, and the whole taking it out before sex sounds like such a hassle, you can’t be spontaneous..which would be annoying.
If you start charting, there are many many sites that can help you along. I use fertilityfriend.com They are sticklers for saying they aren’t a TTA (trying to avoid) site, but I use it as such. I don’t do the whole checking my cervical mucus, or taking my temp..I really need to get on top of that. You can completely prevent pregnancy from checking your cervical mucus, and following your cycles and finding out when you ovulate. But that means 7 days without sex, or sex with a condom.

I think you need to just go back on the pill. Ortho Tri Cyclen is the best, in my experience. That and Estro-Step were ones I loved.
I don’t know. We don’t use any birth control. I follow my cycles, and avoid it when I’m ovulating. We suck at following that, and usually use the pull out method. If I get pregnant then it happens lol

@casheroo: Where do I say that? I was on the pill for 4–5 years, not really taking it toward the end, probably in denial about not really following it? In any event, it’s been quite some time since I’ve actually been taking the pill regularly enough for it to be in any way effective. Sorry for seeming contradictory.

Why do you think my partner has infertility issues? Infertility is associated with endometriosis, which I almost certainly have. And my partner got you pregnant before.

in a prior birth control question you asked, you said you’ve been on the pill for five years. i assumed that was consecutively and recently

Why do you think you have endometriosis? Did you have laproscopic surgery to diagnose it? Or Hysterosonography?
I thought you had possibly been pregnant before, with a prior partner. Or was that just an assumption on his and your part?

@casheroo: I think I have endometriosis because of the insane severity of pain associated with my menstrual cramps. I am not exaggerating when I say that I am rendered completely immobile for an entire day, sweating, shaking, and dizzy from the immense pain in my uterus. Additionally, my cycles are short, and my periods are long and extremely heavy. These are all highly associated with endometriosis. The majority of women who have menstrual cramps that are so severe that they require medical attention have endometriosis. My cramps are unbelievably severe, and I will be going to my gynecologist to discuss this, as well as birth control. Of course I have not had the surgery to diagnose it yet, which is why I said “almost certainly,” rather than “certainly,” which I would be, had it already been diagnosed.

I am uncertain as to whether I had been pregnant before. I (strangely enough) do not remember the results of pregnancy tests taken when I was a teenager, as it was never too relevant since I always started bleeding immensely shortly after worrying I might be pregnant. It is also quite possible that I incorrectly assumed I was having a miscarriage because of the severity of my period, when it reality, that’s just how my period is.

Oh, well just so you know…they put you on the pill for endometriosis. That’s what they did for me, and it helped immensely. It took two months for my pain to become tolerable, but it was much better. They put me on Ortho Tri Cyclen.

It sounds like your main problem with the pill was remembering to take it, right? Did you try an alarm on your cell phone, taking it when a TV show you watch is on, etc.? I don’t know when during the day you were taking it before, but that might make a difference (if you take it in the morning, you potentially have the whole day to take it, if you forget). Also, does your insurance allow you to get multiple packs at once? Some insurances do, and this would be a good way to avoid the other problem. If not, almost all insurances allow you to pick up your next pack halfway through your cycle. If you just make yourself go to the drugstore early, you’ll have a better chance of actually having it when you need it.

You’ve just got to get to the point where it’s habitual. Compared to your concerns with the other forms of bc, remembering to take the pill sounds like the easiest way.

Plus, if you have nasty cramps, the pill will ease those considerably. Or did you not have good results, there?

[mod says] @casheroo and @girlofscience You two obviously have a very intimate and personal knowledge of each other. I might suggest that you move the personal back-and-forth to PM, seeing as how this is a public forum, and anyone and everyone can read your quips.

[mod off] @Dr_C I have no recent experience with prescribing any birth control. I practice infectious diseases (mainly in the hospital), and when I did have an outpatient clinic, it was at the VA hospital with a 100% male patient base (at least in my HIV+ panel). That said, with all of GOS’s caveats, I thought the IUD would serve her well.

I hated Ortho, too. Because it’s tri-cyclic it gave me even crazier mood swings than I already had. I’ve never been on the ring, but heard my friends complain about similar issues. I would not recommend the patch either, as I have heard horror stories. Plus, even despite your suspicion of infertility, if I’m using birth control I want it to be inside of me.
So, with that all said, you might want to consider the depo shot (although I’ve heard of girls gaining crazy amounts of weight on it) or an IUD.
I personally have been on Yasmin or Yaz for the last few years and they’ve been great. They are mono-cyclic pills, which means you take the same type/amount of hormones the whole time (as opposed to Ortho). Fewer crazy mood swings. I switched to Yaz because I am prone to ovarian cysts and it can help prevent them. It also apparently can make your periods shorter, but that really depends.

@casheroo it would depend on the specific product you use… but i’ve read abotu european studies that show a significant decrease in endometriosis related dysmenorrhea with the use of a specific levonorgestrel-releasing intrauterine device… it’s called Mirena.

They revealed the findings from these 2 studies at the World Congress on Endometriosis.

In one study, 40 women with stage I-IV endometriosis and moderate or severe dysmenorrhea underwent first-line conservative laparoscopic surgery with excision or coagulation of endometriosis lesions. They were then randomized to a control group or to postoperative insertion of an IUD that releases 20 [micro]g/ day of 1evonorgestrel. the plastic T-shaped IUD is approved for use in the United States as a contraceptive.

Ten percent of women who used the IUD reported moderate or severe dysmenorrhea, compared with 45% of women in the control group, an absolute risk reduction of 35% using the IUD.

The IUD group reported significantly less dysmenorrhea, dyspareunia, and nonmenstrual pain on a visual analog scale and a verbal rating scale after treatment, compared with the control group. A total of 20% of the 20 patients in the IUD group reported side effects such as bloating, weight gain, and headache.

After 1 year, 75% of patients in the IUD group and 50% in the control group were satisfied or very satisfied with treatment.

Before getting on any other birth control, I suggest you checking with the doctor about your fertility. If your fertility is of no concern to you though, than your best bet is either the shot or the patch.

Now, your reasons against both are mostly vain reasons. They arent good ones imo. You dont want the patch because its not so discrete and leaves a mark which can be washed off? You dont want the shot because of weight gain, even though weight gain can be avoided by watching what you eat and exercise? Than, if you cant handle ANY birth control, just have sex less.

You really should see a doctor to get some good medical advice – both on birth control methods and your painful periods. Ask about easy to use contraceptives, even if the effectiveness is below 90%. Two 75% effective methods used together will statistically result in 93% effectiveness (theoretically). ... and you are probably creative enough to find sexy ways to use them.

@girlofscience You think a condom kills the moment? Try a screaming baby with a loaded diaper! Really though, I have been on every kind of BC out there. I liked the patch the best. Hormones didn’t make me crazy like tri-cyclen and depo did. Used diaphram 3 times when I got off the pill, guess what. Preggers in first cycle. If you think you have endo, get laproscopicly checked. there is NO other way to tell. Is very common, and treatable with patch/pill. As for skin discoloration, I am a mutt(eng, french,spanish and a bunch of other stuff) that tends to tan darkly. I had no problems. I just rotated the patch around my body. It was the best ever! Good luck, and quit tempting fate. Endo can wreak havok on your system, and you could end up with a tubal pregnancy, and you could be really sick before you knew you were even pregnant. Best to you!

@casheroo – thats understandable, I also avoid them too. Especially if I dont need them. If she wants to avoid pregnancy but is having trouble with pills, she can just take a shot and try her best not to give in to the cravings. It takes will power and is hard to do. When I spoke with my doctor she told me that the patch causes dust and gunk to build up around the area where the patch was placed, but she didnt mention actual discolortion of the skin which im assuming might be caused by perhaps the skin becoming tan and the area where the patch is will be left light.

Its all going depend on what you want to do, and what your willing to give up. One of these BC options have to have more pros than cons for your case. Depends on what you value more.

Like @aviona, I am on Yaz now and it seems to help with a lot of the issues I had on other pills…I’ve tried quite a few because of my acne.

I personally didn’t like Ortho Tri Cyclen because it didn’t do anything for my acne.

I would say, if you still need a decision, try Yaz or Yazmin. My gyno really likes it because it works for a lot of women. I’ve been less crazy on Yaz than on some of the other pills I’ve tried.

If you go to bed at the same time every night, take the pill before bed. (I take mine at night because hormones in the morning make me nauseous.) I like the idea @juniper had about taking it during a nightly tv show…during the news, maybe?

Although you don’t like using them, condoms are still an excellent birth control method. There are some very, very thin condoms out there now——Durex brand “Sensi-Thin” condoms are great——they are so thin, it’s like a second skin. No detraction in sensitivity or intimacy. If you add spermicide, the sensitivity and pleasure will be enhanced, and you should be well-protected too.